Natural History of Primary Retroperitoneal Extra-Visceral Perivascular Epithelioid Cell Tumors (PEC): A Study from Transatlantic and Australasian Retroperitoneal Sarcoma Working Group (TARPSWG)
Por:
Mor, E, Apte, S, Mitchell, C, Nessim, C, Almond, M, Vincenzi, B, Lopez, JAG, Cranmer, L, Wagner, MJ, Nissan, A, Abreu, MH, Albertsmeier, M, Knoblauch, M, Barlow, A, Keung, EZ, Grignani, G, Hornick, JL, Gronchi, A, Gyorki, DE
Publicada:
1 oct 2025
Ahead of Print:
1 jul 2025
Resumen:
BackgroundPerivascular epithelioid cell tumors (PEComa) are a rare family of mesenchymal tumors that include several subtypes. There are very limited data describing the natural history of patients with extra-visceral retroperitoneal PEComas of the retroperitoneum. The aim of this study is to describe the clinical features, treatment patterns, outcomes, and diagnostic challenges of primary extra-visceral retroperitoneal or abdominopelvic PEComa over the past decade.Patients and MethodsThis is a retrospective analysis of all extra-visceral, non-renal, retroperitoneal, or abdominopelvic PEComas treated at participating centers over the past 10 years.ResultsA total of 77 patients from 13 centers were included. The median age at diagnosis was 56 years (range 18-81 years); 73% were female. The median size was 9 cm. The tumor was classified as a PEComa not otherwise specified (NOS) in 55 (71%), sclerosing PEComa in 11 (15%), and angiomyolipoma (AML) in 11 (15%). Treatment intent was curative in 59 (77%) patients. Adjuvant radiation was given in five (8%) patients, and (neo)adjuvant systemic therapy was given to six (10%). Of those who did not undergo curative intent treatment, four (22%) patients had metastatic disease and three (17%) had primary unresectable disease. With a median follow-up of 26 months (2.3-147 months), 24 (40%) of the 59 patients having curative treatment had recurred. Recurrence rates differed by subtype, with 20 (37%) of the PEComa NOS group, 3 (27%) of the sclerosing PEComa group, and 1 (9%) of the AML group developing recurrence. The estimated 5-year OS of the whole cohort was 63% and 75% for the curative intent group.ConclusionsRetroperitoneal and abdominopelvic PEComas show distinct behaviors by subtype. PEComa NOS had the highest recurrence and mortality, sclerosing PEComa showed intermediate risk, and AML was indolent. Histological classification is essential for prognosis and management.
Filiaciones:
Mor, E:
Univ Melbourne, Peter MacCallum Canc Ctr, Sir Peter MacCallum Dept Oncol, Melbourne, Vic, Australia
Sheba Med Ctr, Ramat Gan, Israel
Apte, S:
Univ Melbourne, Peter MacCallum Canc Ctr, Sir Peter MacCallum Dept Oncol, Melbourne, Vic, Australia
Univ Ottawa, Ottawa, ON, Canada
Mitchell, C:
Univ Melbourne, Peter MacCallum Canc Ctr, Sir Peter MacCallum Dept Oncol, Melbourne, Vic, Australia
Nessim, C:
Univ Ottawa, Ottawa, ON, Canada
Almond, M:
Univ Hosp Birmingham NHS Fdn Trust, Birmingham, England
Vincenzi, B:
Univ Campus Biomed, Rome, Italy
Lopez, JAG:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Cranmer, L:
Univ Washington, Seattle, WA USA
Wagner, MJ:
Dana Farber Canc Inst, Boston, MA USA
Nissan, A:
Sheba Med Ctr, Ramat Gan, Israel
Abreu, MH:
Portuguese Inst Oncol Porto, Porto, Portugal
Albertsmeier, M:
Ludwig Maximilians Univ LMU Munich, LMU Univ Hosp, Munich, Germany
Knoblauch, M:
Ludwig Maximilians Univ LMU Munich, LMU Univ Hosp, Munich, Germany
Barlow, A:
Leeds Teaching Hosp NHS Trust, Leeds, England
Keung, EZ:
Univ Texas MD Anderson, Houston, TX USA
Grignani, G:
Inst Canc Res & Treatment IRCC Candiolo, Candiolo, Italy
Hornick, JL:
Harvard Med Sch, Brigham & Womens Hosp, Boston, MA USA
Gronchi, A:
Fdn IRCCS Ist Nazl Tumori, Milan, Italy
Gyorki, DE:
Peter MacCallum Canc Ctr, Div Canc Surg, Melbourne, Vic, Australia
Green Submitted, hybrid
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